Coalition Prompts Louisiana Medicaid Policy Change

February 12, 2020

On receiving reports from Louisiana providers that the state Medicaid agency had implemented a policy requiring 10 minutes of service to be rendered before a unit of service could be billed with the adaptive behavior (ABA) services CPT codes, the ABA Coding Coalition asked Louisiana Medicaid to rescind the policy and replace it with the American Medical Association’s CPT® rounding rule, which allows a unit of service to be reported for time-based codes after the halfway point is reached — that’s 8 minutes for codes 97151-97158, 0362T, and 0373T because all are 15-minute codes. Here is Louisiana Medicaid’s letter indicating their agreement with the changes requested by the Coalition.